Persons with disabilities represent about 17 percent of the population but account for as much as 47 percent of medical care expenditures. These high costs can be attributed, in part, to secondary conditions. Both the Surgeon General of the United States and Healthy People 2010 call for efforts to prevent and manage secondary conditions experienced by this vulnerable population. Such efforts may also substantially reduce medical services utilization and associated costs. Data suggest that several secondary conditions experienced by adults with intellectual and developmental disabilities (I/DD) are related to inadequate nutrition and that nutritional environments in supported living arrangements may not meet dietary standards. Yet, there are no convenient and reliable methods for assessing dietary intake for this population. The long-term objective of this research is to is to improve the food habits and practices of adults with I/DD who live in supported arrangements in the community. The specific aim of this project is to test the reliability and validity of an innovative method, Food On Film, for assessing the dietary intake of adults with significant cognitive impairments living in the community. Three studies are proposed to test this novel yet simple approach in settings with successively less control; from highly controlled standardized settings to home settings where people routinely eat. In the first study, 30 dieticians will use a standard set of photographs taken by researchers following the Food on Film protocol to develop food lists and to assign number of servings to each food group. Their assessments will be compared to a "gold standard" measure of weighed food records. In the second study, 15 adults with I/DD will follow the same protocol to take pictures of meals they select and consume in a highly controlled situation. Again, researchers will compare the dieticians' review of the Food On Film photos to the standard, with particular attention to the ability of dieticians to produce accurate assessments across the food groups. In the third study, the same 15 adults with I/DD will use the Food On Film Kit to record dietary intake at home. Again, researchers will assess reliability and consistency of assessments prepared by the dieticians. [unreadable] [unreadable] [unreadable]